There's a common misconception that if you like to meticulously organize your things, keep your hands clean, or plan out your weekend to the last detail, you might have OCD. In fact, OCD, which stands for obsessive compulsive disorder, is a serious psychiatric condition that is frequently misunderstood by society and mental health professionals alike. So let's start by debunking some myths. Myth one: repetitive or ritualistic behaviors are synonymous with OCD. As its name suggests, obsessive compulsive disorder has two aspects: the intrusive thoughts, images, or impulses, known as obsessions, and the behavioral compulsions people engage in to relieve the anxiety the obsessions cause. The kinds of actions that people often associate with OCD, like excessive hand washing, or checking things repeatedly, may be examples of obsessive or compulsive tendencies that many of us exhibit from time to time. But the actual disorder is far more rare and can be quite debilitating. People affected have little or no control over their obsessive thoughts and compulsive behaviors, which tend to be time consuming and interfere with work, school or social life to the point of causing significant distress. This set of diagnostic criteria is what separates people suffering from OCD from those who may just be a bit more meticulous or hygiene obsessed than usual. Myth two: the main symptom of OCD is excessive hand washing. Although hand washing is the most common image of OCD in popular culture, obsessions and compulsions can take many different forms. Obsessions can manifest as fears of contamination and illness, worries about harming others, or preoccupations with numbers, patterns, morality, or sexual identity. And compulsions can range from excessive cleaning or double checking, to the fastidious arrangement of objects, or walking in predetermined patterns. Myth three: individuals with OCD don't understand that they are acting irrationally. Many individuals with OCD actually understand the relationship between their obsessions and compulsions quite well. Being unable to avoid these thoughts and actions despite being aware of their irrationality is part of the reason why OCD is so distressing. OCD sufferers report feeling crazy for experiencing anxiety based on irrational thoughts and finding it difficult to control their responses. So what exactly causes OCD? The frustrating answer is we don't really know. However, we have some important clues. OCD is considered a neurobiological disorder. In other words, research suggests that OCD sufferers brains are actually hardwired to behave in a certain fashion. Research has implicated three regions of the brain variously involved in social behavior and complex cognitive planning, voluntary movement, and emotional and motivational responses. The other piece of the puzzle is that OCD is associated with low levels of serotonin, a neurotransmitter that communicates between brain structures and helps regulate vital processes, such as mood, aggression, impulse control, sleep, appetite, body temperature and pain. But are serotonin and activity in these brain regions the sources of OCD or symptoms of an unknown underlying cause of the disorder. We probably won't know until we have a much more intimate understanding of the brain. The good news is there are effective treatments for OCD, including medications, which increase serotonin in the brain by limiting its reabsorption by brain cells, behavioral therapy that gradually desensitizes patients to their anxieties, and in some cases, electroconvulsive therapy, or surgery, when OCD doesn't respond to other forms of treatment. Knowing that your own brain is lying to you while not being able to resist its commands can be agonizing. But with knowledge and understanding comes the power to seek help, and future research into the brain may finally provide the answers we're looking for.
人們常有這樣的誤解- 如果你喜歡一絲不苟地 擺設自己的東西、 保持雙手乾淨、 或是巨細靡遺地計畫好週末 你可能有了「OCD」吧! 事實上OCD代表的是「强迫症」 是一種極端的精神官能狀況 經常被社會和像心理醫師的人所誤解 讓我們先從破解幾項迷思做開端 迷思一、重複或例行公事般的行為 就等同於强迫症 一如其名強迫症有兩方面- 擾人的念頭、影像, 和被叫做執迷的強烈衝動 以及有強迫症的人遂行了行為上的 強烈衝動以舒解執迷所引發的焦慮 人們時常把某幾類作為牽扯上强迫症 像是太常洗手或是反覆檢查東西 或者是我們之中多數人不時表現出來 執迷或是強烈衝動傾向的例子 但是真正的病症極為罕見 而且相當折騰人 得病的人不太能或根本無法 控制執迷的念頭和衝動的行為 那是會耗費時間而且干擾工作、 上學與社交生活 甚至會引發嚴重的憂鬱 這類診斷標準區分出受强迫症所苦的人 和可能不過是比一般人有點過於 一絲不茍或是執迷於衛生的那些人 迷思二、强迫症的主要症狀是太常洗手 雖然洗手是普眾文化中 最常見的強迫症畫面 不過執迷與強烈的衝動卻能夠 用許多不同的方式體現 執迷可以當成對感染與疾病的恐懼、 擔心傷害到其他人、 或是滿腦子只在乎數字、 形式、道義、性別認定等 而强烈的衝動可以從 過度清潔或反覆檢查 甚至到過分嚴謹的擺設物品 或是以既定的方式、規矩在走路 迷思三、患有強迫症的人在當下 並不曉得他們是非理性地在做事 很多强迫症患者事實上清楚知道 執迷與強烈衝動之間的關聯 儘管意識到他們的不合理性 但無法避開這些念頭和動作 就是強迫症為什麼這麼令人 憂鬱的部分原因 強迫症患者們說基於不合理的想法 和控制不住的反應 所經歷的焦慮令其覺得像發瘋了一樣 那到底是什麽引起强迫症呢? 令人灰心的答案是我們並不清楚 然而我們是有一些重要的線索 强迫症被認爲是神經生理失調 換言之研究顯示强迫症患者的大腦 事實上早被限定了 要做出特定風格之舉動 研究指向大腦的三個區塊 分別涉入了社交行為、複雜的認知建立、 自主性動作以及情緒與幹勁的反應 其他費解的地方是強迫症與 低水平的血清素有關 一種在大腦組織之間 傳遞資訊的神經傳遞素 幫助管制極重要的過程 例如心情、犯意、脈搏控制、 睡眠、食慾、體溫和疼痛 是否血清素和這些大腦區塊中的 活動就是强迫症的根源? 或者某種未知的症狀 暗藏了精神不正常的成因? 直到我們更通曉大腦前 我們可能不得而知 好消息是對強迫症有效的療法是存在的 包括了增加大腦內血清素的藥物 阻止血清素被大腦細胞再吸收回去 以及使病人對焦慮逐漸 感到麻木的行為療法 當強迫症對其他療法沒反應時 部分案例中就用電療或是做手術 知道自己的大腦正在説謊 這時候又無法抗拒它的指令 會是非常痛苦的事 不過有了知識和理解它 就能得到求救的力量 而未來對大腦內的研究 也許最終會提供給我們 此時正在尋找的解答